Provider Demographics
NPI:1447272315
Name:SONPAL, GIRISHKUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:GIRISHKUMAR
Middle Name:
Last Name:SONPAL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4401 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE L2A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3028
Mailing Address - Country:US
Mailing Address - Phone:718-445-0500
Mailing Address - Fax:718-717-0286
Practice Address - Street 1:4401 FRANCIS LEWIS BLVD
Practice Address - Street 2:SUITE L2A
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3028
Practice Address - Country:US
Practice Address - Phone:718-445-0500
Practice Address - Fax:718-717-0286
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY122605207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY18286Medicare PIN
NYC66855Medicare UPIN